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EP2776108B1 - Cathéter guide extensible - Google Patents

Cathéter guide extensible Download PDF

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Publication number
EP2776108B1
EP2776108B1 EP12791617.9A EP12791617A EP2776108B1 EP 2776108 B1 EP2776108 B1 EP 2776108B1 EP 12791617 A EP12791617 A EP 12791617A EP 2776108 B1 EP2776108 B1 EP 2776108B1
Authority
EP
European Patent Office
Prior art keywords
tubular member
catheter
distal
guide extension
proximal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP12791617.9A
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German (de)
English (en)
Other versions
EP2776108A2 (fr
Inventor
Huisun Wang
Joel M. Wasdyke
Wayne Falk
Brian R. Reynolds
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Boston Scientific Scimed Inc
Original Assignee
Scimed Life Systems Inc
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Publication date
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Publication of EP2776108A2 publication Critical patent/EP2776108A2/fr
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/0069—Tip not integral with tube
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0102—Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M2025/0004—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system

Definitions

  • the present disclosure pertains to medical devices, and more particularly to elongated intracorporeal medical devices including a guide extension catheter.
  • a wide variety of intracorporeal medical devices have been developed for medical use, for example, intravascular use. Some of these devices include guidewires, catheters, and the like. These devices are manufactured by any one of a variety of different manufacturing methods and may be used according to any one of a variety of methods.
  • US 2001/018574 A1 relates to a single operator drainage catheter delivery system and method of use.
  • the delivery system includes a guide member having a guidewire lumen extending through a distal portion thereof, with a proximal guidewire port located distal of the proximal end.
  • a placement catheter disposed over the guide member has a catheter lumen extending through a distal portion thereof, with a proximal guidewire port located distal of the proximal end.
  • a drainage catheter is disposed about the guide member distal of the placement catheter.
  • each has certain advantages and disadvantages. There is an ongoing need to provide alternative medical devices as well as alternative methods for manufacturing and using medical devices.
  • the present invention relates to a guide extension catheter.
  • the guide extension catheter includes a proximal tubular member having a lumen defined therein.
  • a distal tubular member is attached to the proximal tubular member with a wire member that extends between the proximal and distal tubular members.
  • the proximal tubular member has an outer diameter.
  • the distal tubular member has an inner diameter. The inner diameter of the distal tubular member is greater than the outer diameter of the proximal tubular member.
  • a stiffening member is slidably disposed within the proximal tubular member.
  • An example catheter system may include a guide catheter having a distal end.
  • a guide extension catheter may be disposed within the guide catheter.
  • the guide extension catheter may include a proximal tubular member having a lumen defined therein, a distal tubular member attached to the proximal tubular member, and a stiffening member slidably disposed within the proximal tubular member.
  • a distal end of the guide extension catheter may be configured to extend distally beyond the distal end of the guide catheter and into a coronary artery.
  • a treatment catheter may be disposed within the guide catheter.
  • An example method may include providing a guide catheter, advancing the guide catheter through a blood vessel to a position adjacent to an ostium of a coronary artery, and providing a guide extension catheter.
  • the guide extension catheter may include a proximal tubular member having a lumen defined therein, a distal tubular member attached to the proximal tubular member, and a stiffening member slidably disposed within the proximal tubular member.
  • the method may also include advancing the guide extension catheter through the guide catheter to a position where at least a portion of the distal tubular member extends distally beyond a distal end of the guide catheter and into the coronary artery and advancing a treatment catheter through the guide catheter.
  • a guide catheter 10 may be advanced through a blood vessel such as the aorta A to a position adjacent to the ostium O of a (e.g., left and/or right) coronary artery CA as illustrated in Figure 1 .
  • a treatment catheter e.g., balloon catheter, stent delivery system, etc.
  • the coronary artery CA may be advanced through guide catheter 10 and into the coronary artery CA to a target location where the treatment catheter may be used to perform the appropriate cardiac intervention.
  • the guide catheter 10 may lose its positioning or otherwise be shifted so that it no longer is positioned to efficiently guide the treatment catheter to the coronary arteries. This may include a distal end 12 of guide catheter 10 being shifted away from the ostium O of the coronary artery CA. Because of the shift away from the ostium O, access to the coronary arteries CA may require repositioning of guide catheter 10 in order to bring the distal end 12 back into engagement with the ostium O of the coronary artery CA.
  • Figure 2 illustrates a guide extension catheter 14 extending through guide catheter 10 and beyond distal end 12 of guide catheter 10 into the coronary artery CA. Because, for example, guide extension catheter 14 may extend beyond distal end 12 of guide catheter 10, guide extension catheter 14 may extend beyond the ostium O of the coronary artery CA and into a portion of the coronary artery CA. By extending beyond the ostium O, guide extension catheter 14 may stabilize the positioning of guide catheter 10 and allow for improved access to the coronary artery CA for a number of cardiac interventions.
  • Figure 3 is a cross-sectional side view of guide extension catheter 14.
  • guide extension catheter 14 may include a proximal tubular member 16 and a distal tubular member 18.
  • Proximal tubular member 16 may define or otherwise include a lumen 20.
  • lumen 20 extends along the entire length of proximal tubular member 16.
  • lumen 20 extends along only a portion of the length of proximal tubular member 16.
  • proximal tubular member may include both proximal and distal openings (e.g., positioned at the proximal and distal end of proximal tubular member 16) such that lumen 20 is "open" on both ends.
  • proximal tubular member 16 may be closed or otherwise sealed.
  • distal end of proximal tubular member 16 may be closed.
  • proximal tubular member 16 may have an opening or port (not shown) formed in the wall of proximal tubular member 16 and spaced from the proximal and/or distal end of proximal tubular member 16. The port may or may not be in fluid communication with lumen 20.
  • Distal tubular member 18 may also define or otherwise include a lumen 21.
  • lumen 21 (and/or the inner diameter of distal tubular member 18) may be larger than lumen 20 (and/or the inner diameter of proximal tubular member 16) and may be larger than the outer diameter of proximal tubular member 16.
  • lumen 21 may be sufficiently large so as to allow a therapeutic catheter (e.g., balloon catheter, stent delivery system, etc.) to pass therethrough.
  • a therapeutic catheter e.g., balloon catheter, stent delivery system, etc.
  • the therapeutic catheter may extend within guide catheter 10 alongside proximal tubular member 16 and through lumen 21 of distal tubular member 18.
  • Distal tubular member 18 may be attached to proximal tubular member 16.
  • the arrangement and/or configuration of the attachment between proximal tubular member 16 and distal tubular member 18 may vary.
  • distal tubular member 18 may have an opening or lumen 22 formed in tube wall thereof and proximal tubular member 16 may be disposed within opening 22. This may include necking or pinching down (in some embodiments including closing the distal end of proximal tubular member 16) proximal tubular member 16 and inserting the necked down portion into opening 22.
  • inserting proximal tubular member 16 into opening 22 may secure tubular members 16/18 via a mechanical bond.
  • additional and/or alternative bonding may be utilized including those bonding mechanisms commonly used for medical devices (e.g., adhesive bonding, welding, thermal bonding, brazing, etc.).
  • Other attachment mechanisms are also contemplated for attaching proximal tubular member 16 to distal tubular member 18 including direct bonding (e.g., adhesive bonding, thermal bonding, welding, brazing, etc.), bonding that is facilitated by a third component (e.g., a metal or polymer collar bonded between the proximal tubular member 16 and the distal tubular member 18), etc.
  • stiffening member 24 may be slidably disposed within lumen 20. Alternatively, the stiffening member 24 may be fixed to proximal tubular member 16 within lumen 20. As the name suggests, stiffening member 24 may allow the stiffness of guide extension catheter 14 to be varied and may improve the pushability of guide extension catheter 14. For example, stiffening member 24 may be advanced distally within lumen 20 of proximal tubular member 16 (e.g., to a position at or near the distal end of proximal tubular member 16) to add enhanced stiffness to guide extension catheter 14.
  • stiffening member 24 can be proximally retracted or even removed completely from lumen 20 when more flexibility is desired or at another suitable time (e.g., when distal tubular member 18 is disposed within guide catheter 10 such that a portion of distal tubular member 18 extends distally beyond distal end 12 of guide catheter 10).
  • proximal tubular member 16 may include a nickel-titanium alloy (e.g., nitinol), nylon, polyether block amide, polyurethane, and/or the like.
  • distal tubular member 18 may include a polymer.
  • distal tubular member 18 may include a multilayer structure including, for example, an inner polymer layer, an outer polymer layer, and a reinforcement (e.g., a braid, coil, mesh, or the like) disposed therebetween.
  • stiffening member 24 may include a nickel-titanium alloy, stainless steel, etc. These are just examples. Other materials are contemplated including those disclosed herein.
  • stiffening member 24 may have a variety of configurations including configurations with a stiffer proximal portion and a more flexible distal portion.
  • the dimensions and/or configurations of stiffening member 24 may vary.
  • the outer diameter of stiffening member 24 may be smaller than the inner diameter of guide extension catheter 14 and, for example, stiffening member 24 may have a proximal outer diameter that is equal to or smaller than proximal tubular member 16.
  • Guide extension catheter 14 may also include a number of coatings that may, for example, reduce friction.
  • proximal tubular member 16 may have an inner and/or outer coating that includes a hydrophilic polymer that may reduce friction during tracking.
  • An example coating may include BAYER CL-100, BIOSLIDE, NG-HPC, or the like.
  • Stiffening member 24 may also be coated, for example, to reduce friction during tracking.
  • stiffening member 24 may be coated with silicone, SLIP COAT, MDX, or the like. These are just examples. Other materials are contemplated including those disclosed herein.
  • guide extension catheter 14 may include advancing guide catheter 10 through a blood vessel to a position at and/or within the ostium O of a coronary artery CA, inserting a guidewire into the coronary artery CA by advancing the guidewire through guide catheter 10, and advancing guide extension catheter 14 through guide catheter 10.
  • Stiffening member 24 may or may not be disposed within proximal tubular member 16 during advancement of guide extension catheter 14 through guide catheter 10.
  • the position of stiffening member 24 may also be adjusted (including removal of stiffening member 24) during and/or after advancement of guide catheter extension, for example, in order to adjust the stiffness and to allow distal tubular member 18 to be positioned in the manner desired within guide catheter 10 (e.g., where a portion of distal tubular member 18 extends distally from distal end 12 of guide catheter).
  • a therapeutic catheter e.g., balloon catheter, stent delivery system, etc.
  • Figure 4 illustrates guide extension catheter 14 disposed within guide catheter 10 (e.g., disposed within a lumen 26 defined within guide catheter 10).
  • distal tubular member 18 may be arranged to extend distally out from distal end 12 of guide catheter 10.
  • distal tubular member 18 may engage the ostium O and/or extend within a portion of the coronary artery CA to help maintain the position of guide catheter 10 and improve access to the coronary artery CA.
  • Figure 5 is a cross-sectional view taken through line 5-5 in Figure 4 .
  • proximal tubular member 16 may be designed to be sufficiently small (while still being sufficiently sized and configured for pushability) so as to take up relatively little space within the interior or lumen 26 of guide catheter 10.
  • guide extension catheter 14 allows for a therapeutic catheter or medical device to be advanced through guide catheter 10 in order to reach the desired target location for the intervention.
  • proximal tubular member 16 may contact the inner wall surface of guide catheter 10, which may provide even more space.
  • Figure 6 is a cross-sectional side view of another example guide extension catheter 114 that may be similar in form and function to other guide extension catheters disclosed herein.
  • Guide extension catheter 114 may include proximal tubular member 116 and distal tubular member 118.
  • Stiffening member 124 may be slidably disposed within lumen 120 of proximal tubular member 116.
  • a wire member 128 may extend between and connect proximal tubular member 116 with distal tubular member 118. In some embodiments, wire member 128 may attach to a pinched off distal end of proximal tubular member 116. However, in other embodiments, wire member 128 may simply attach to proximal tubular member 116.
  • wire member 128 may be attached to an inner wall surface of proximal tubular member 116 (e.g., wire member 128 may extend within lumen 120 and attach to the inner wall surface of proximal tubular member 116), wire member 128 may be attached to an outer wall surface of proximal tubular member 116, wire member 128 may abut the distal end of proximal tubular member 116, etc.
  • Figure 7 is a cross-sectional side view of another example guide extension catheter 214 that may be similar in form and function to other guide extension catheters disclosed herein.
  • Guide extension catheter 214 may include proximal tubular member 216 and distal tubular member 218.
  • guide extension catheter 214 is shown disposed within guide catheter 10.
  • Proximal tubular member 216 may include a plurality of tubes, tube segments, lumens or members.
  • proximal tubular member 216 may include three tubular members 216a/216b/216c (which can be seen in Figure 8 ) that collectively define proximal tubular member 216.
  • Tubular members 216a/216b/216c may be attached to one another (e.g., with an adhesive bond, thermal bond, weld, braze, etc.) or a sleeve (not shown) may be disposed about tubular members 216a/216b/216c to attach tubular members 216a/216b/216c to one another. In other embodiments, tubular members 216a/216b/216c may not be attached to one another.
  • One or more stiffening members 224a/224b/224c may be disposed within tubular members 216a/216b/216c, which may have a similar form and function to other stiffening members disclosed herein.
  • proximal tubular member 216 is illustrated as including three tubular members 216a/216b/216c, this is not intended to be limiting as any suitable number of tubular members may be utilized (e.g., one, two, three, four, five, six, seven, eight, nine, ten, etc.).
  • Figure 8 is a cross-sectional view taken through line 8-8 in Figure 7 .
  • tubular members 216a/216b/216c may be seen.
  • tubular members 216a/216b/216c may be arranged in an arcuate or curved arrangement that may follow or trace the interior wall of guide catheter 10. This may improve the amount of space within guide catheter 10 through which a treatment catheter may be advanced through.
  • tubular members 216a/216b/216c may contact the inner wall surface of guide catheter 10, which may provide even more space.
  • Figure 9 is a cross-sectional side view of another example guide extension catheter 314 that may be similar in form and function to other guide extension catheters disclosed herein.
  • Guide extension catheter 314 may include proximal tubular member 316 and distal tubular member 318.
  • Stiffening member 324 may be slidably disposed within lumen 320 of proximal tubular member 316.
  • distal tubular member 318 may include a skived or slanted proximal end 330.
  • Figure 10 is a cross-sectional side view of another example guide extension catheter 414 that may be similar in form and function to other guide extension catheters disclosed herein.
  • Guide extension catheter 414 may include proximal tubular member 416 and distal tubular member 418.
  • proximal tubular member 416 may extend within distal tubular member 418.
  • proximal tubular member 416 may extend along an interior wall surface of distal tubular member 418 to a position at or near the distal end of distal tubular member 418.
  • the outer wall surface of proximal tubular member 416 may be attached to the inner wall surface of distal tubular member 418.
  • proximal tubular member 416 may have an open distal end. However, in other embodiments, proximal tubular member 416 may be necked down and/or sealed at its distal end. This may prevent fluid from travelling flowing through lumen 420 and out from the patient during an intervention.
  • Stiffening member 424 may extend through lumen 420 of proximal tubular member 416. Because proximal tubular member 416 may be disposed within distal tubular member 418, stiffening member 424 may also extend within distal tubular member 418 (e.g., while within proximal tubular member 416). In some embodiments, proximal tubular member 416 may terminate proximally of the distal end of distal tubular member 418. In these embodiments, stiffening member 424 may extend distally from proximal tubular member 416 and within distal tubular member 418.
  • proximal tubular member 16 and distal tubular member 18 may vary.
  • this is not intended to limit the devices and methods described herein, as the discussion may be applied to other similar tubular members and/or components of tubular members or devices disclosed herein.
  • Proximal tubular member 16 and distal tubular member 18 and/or other components of guide extension catheter 14 may be made from a metal, metal alloy, polymer (some examples of which are disclosed below), a metal-polymer composite, ceramics, combinations thereof, and the like, or other suitable material.
  • suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic and/or super-elastic nitinol; other nickel alloys such as nickel-chromium-molybdenum alloys (e.g., UNS: N06625 such as INCONEL® 625, UNS: N06022 such as HASTELLOY® C-22®, UNS: N10276 such as HASTELLOY® C276®, other HASTELLOY® alloys, and the like), nickel-copper alloys (e.g., UNS: N04400 such as MONEL® 400, NICKELVAC® 400, NICORROS® 400, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nickel-molybdenum alloys (e.g.,
  • Linear elastic and/or non-super-elastic nitinol may be distinguished from super elastic nitinol in that the linear elastic and/or non-super-elastic nitinol does not display a substantial "superelastic plateau” or “flag region” in its stress/strain curve like super elastic nitinol does.
  • linear elastic and/or non-super-elastic nitinol as recoverable strain increases, the stress continues to increase in a substantially linear, or a somewhat, but not necessarily entirely linear relationship until plastic deformation begins or at least in a relationship that is more linear that the super elastic plateau and/or flag region that may be seen with super elastic nitinol.
  • linear elastic and/or non-super-elastic nitinol may also be termed "substantially" linear elastic and/or non-super-elastic nitinol.
  • linear elastic and/or non-super-elastic nitinol may also be distinguishable from super elastic nitinol in that linear elastic and/or non-super-elastic nitinol may accept up to about 2-5% strain while remaining substantially elastic (e.g., before plastically deforming) whereas super elastic nitinol may accept up to about 8% strain before plastically deforming. Both of these materials can be distinguished from other linear elastic materials such as stainless steel (that can also can be distinguished based on its composition), which may accept only about 0.2 to 0.44 percent strain before plastically deforming.
  • the linear elastic and/or non-super-elastic nickel-titanium alloy is an alloy that does not show any martensite/austenite phase changes that are detectable by differential scanning calorimetry (DSC) and dynamic metal thermal analysis (DMTA) analysis over a large temperature range.
  • DSC differential scanning calorimetry
  • DMTA dynamic metal thermal analysis
  • the mechanical bending properties of such material may therefore be generally inert to the effect of temperature over this very broad range of temperature.
  • the mechanical bending properties of the linear elastic and/or non-super-elastic nickel-titanium alloy at ambient or room temperature are substantially the same as the mechanical properties at body temperature, for example, in that they do not display a super-elastic plateau and/or flag region.
  • the linear elastic and/or non-super-elastic nickel-titanium alloy maintains its linear elastic and/or non-super-elastic characteristics and/or properties.
  • the linear elastic and/or non-super-elastic nickel-titanium alloy may be in the range of about 50 to about 60 weight percent nickel, with the remainder being essentially titanium. In some embodiments, the composition is in the range of about 54 to about 57 weight percent nickel.
  • a suitable nickel-titanium alloy is FHP-NT alloy commercially available from Furukawa Techno Material Co. of Kanagawa, Japan. Some examples of nickel titanium alloys are disclosed in U.S. Patent Nos. 5,238,004 and 6,508,803 . Other suitable materials may include ULTANIUMTM (available from Neo-Metrics) and GUM METALTM (available from Toyota).
  • a superelastic alloy for example a superelastic nitinol can be used to achieve desired properties.
  • portions or all of proximal tubular member 16 and/or distal tubular member 18 may also be doped with, made of, or otherwise include a radiopaque material.
  • Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique during a medical procedure. This relatively bright image aids the user of guide extension catheter 14 in determining its location.
  • Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, polymer material loaded with a radiopaque filler, and the like. Additionally, other radiopaque marker bands and/or coils may also be incorporated into the design of guide extension catheter 14 to achieve the same result.
  • a degree of Magnetic Resonance Imaging (MRI) compatibility is imparted into guide extension catheter 14.
  • proximal tubular member 16 and distal tubular member 18, or portions thereof may be made of a material that does not substantially distort the image and create substantial artifacts (i.e., gaps in the image). Certain ferromagnetic materials, for example, may not be suitable because they may create artifacts in an MRI image.
  • Proximal tubular member 16 and distal tubular member 18, or portions thereof may also be made from a material that the MRI machine can image.
  • Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like), nickel-cobalt-chromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nitinol, and the like, and others.
  • cobalt-chromium-molybdenum alloys e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like
  • nickel-cobalt-chromium-molybdenum alloys e.g., UNS: R30035 such as MP35-N® and the like
  • nitinol and the like, and others.
  • a sheath or covering may be disposed over portions or all of proximal tubular member 16 and distal tubular member 18 that may define a generally smooth outer surface for guide extension catheter 14. In other embodiments, however, such a sheath or covering may be absent from a portion of all of guide extension catheter 14, such that proximal tubular member 16 and distal tubular member 18 may form the outer surface.
  • the sheath may be made from a polymer or other suitable material.
  • suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polyether block ester, polyurethane (for example, Polyurethane 85A), polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, ARNITEL® available from DSM Engineering Plastics), ether or ester based copolymers (for example, butylene/poly(alkylene ether) phthalate and/or other polyester elastomers such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example available under the trade name PEBAX®), ethylene vinyl acetate
  • the exterior surface of the guide extension catheter 14 may be sandblasted, beadblasted, sodium bicarbonate-blasted, electropolished, etc.
  • a coating for example a lubricious, a hydrophilic, a protective, or other type of coating may be applied over portions or all of the sheath, or in embodiments without a sheath over portion of proximal tubular member 16 and distal tubular member 18, or other portions of guide extension catheter 14.
  • the sheath may comprise a lubricious, hydrophilic, protective, or other type of coating.
  • Hydrophobic coatings such as fluoropolymers provide a dry lubricity which improves guidewire handling and device exchanges.
  • Lubricious coatings improve steerability and improve lesion crossing capability.
  • Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof.
  • HDPE high-density polyethylene
  • PTFE polytetrafluoroethylene
  • polyarylene oxides polyvinylpyrolidones
  • polyvinylalcohols polyvinylalcohols
  • hydroxy alkyl cellulosics algins
  • Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility.
  • Some other examples of such coatings and materials and methods used to create such coatings can be found in U.S. Patent Nos. 6,139,510 and 5,772,609 .
  • the coating and/or sheath may be formed, for example, by coating, extrusion, co-extrusion, interrupted layer co-extrusion (ILC), or fusing several segments end-to-end.
  • the layer may have a uniform stiffness or a gradual reduction in stiffness from the proximal end to the distal end thereof. The gradual reduction in stiffness may be continuous as by ILC or may be stepped as by fusing together separate extruded tubular segments.
  • the outer layer may be impregnated with a radiopaque filler material to facilitate radiographic visualization. Those skilled in the art will recognize that these materials can vary widely without deviating from the scope of the present invention.

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Claims (12)

  1. Cathéter guide extensible (114) comprenant :
    un élément tubulaire proximal (116) ayant une lumière (120) définie à l'intérieur de ce dernier ;
    un élément tubulaire distal (118) fixé sur l'élément tubulaire proximal (116) ; et
    un élément de renforcement (124) disposé, de manière coulissante, à l'intérieur de l'élément tubulaire proximal (116) ;
    dans lequel l'élément tubulaire proximal (116) a un diamètre externe, dans lequel l'élément tubulaire distal (118) a une diamètre interne, et dans lequel le diamètre interne de l'élément tubulaire distal (118) est supérieur au diamètre externe de l'élément tubulaire proximal (116) ; et
    dans lequel l'élément tubulaire proximal (116) est fixé à l'élément tubulaire distal (118) avec un élément de fil (128) qui s'étend entre l'élément tubulaire proximal (116) et l'élément tubulaire distal (118).
  2. Cathéter guide extensible selon la revendication 1, dans lequel l'élément tubulaire proximal comprend un alliage de nickel-titane.
  3. Cathéter guide extensible selon l'une quelconque des revendications 1 à 2, dans lequel l'élément tubulaire proximal a une extrémité proximale ouverte et une extrémité distale fermée.
  4. Cathéter guide extensible selon l'une quelconque des revendications 1 à 3, dans lequel l'élément tubulaire distal comprend une couche de polymère interne et une couche de polymère externe, et une couche de renforcement disposée entre la couche de polymère interne et la couche de polymère externe.
  5. Cathéter guide extensible selon l'une quelconque des revendications 1 à 4, dans lequel l'élément de renforcement comprend de l'acier inoxydable.
  6. Cathéter guide extensible selon l'une quelconque des revendications 1 à 5, dans lequel l'élément tubulaire distal a une lumière de paroi formée dans une paroi de tube de l'élément tubulaire distal et dans lequel l'élément tubulaire proximal est disposé dans la lumière de paroi.
  7. Cathéter guide extensible selon l'une quelconque des revendications 1 à 6, dans lequel l'élément tubulaire proximal comprend une pluralité de tubes qui sont couplés entre eux.
  8. Cathéter guide extensible selon l'une quelconque des revendications 1 à 7, dans lequel une région d'extrémité proximale de l'élément tubulaire distal est biseautée.
  9. Cathéter guide extensible selon l'une quelconque des revendications 1 à 8, dans lequel l'élément tubulaire proximal a une région distale qui s'étend vers une extrémité distale de l'élément tubulaire distal.
  10. Cathéter guide extensible selon l'une quelconque des revendications 1 à 9, dans lequel le cathéter guide extensible est disposé à l'intérieur d'un cathéter guide.
  11. Cathéter guide extensible selon la revendication 10, dans lequel l'élément tubulaire distal a un diamètre externe qui est sensiblement le même que le diamètre interne du cathéter guide.
  12. Cathéter guide extensible selon l'une quelconque des revendications 10 à 11, dans lequel un cathéter de traitement est disposé à l'intérieur du cathéter guide.
EP12791617.9A 2011-11-09 2012-11-07 Cathéter guide extensible Active EP2776108B1 (fr)

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US201161557766P 2011-11-09 2011-11-09
PCT/US2012/063933 WO2013070758A2 (fr) 2011-11-09 2012-11-07 Cathéter guide extensible

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EP2776108B1 true EP2776108B1 (fr) 2019-07-17

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WO2013070758A3 (fr) 2013-07-04
WO2013070758A2 (fr) 2013-05-16
US9993613B2 (en) 2018-06-12
US20130116701A1 (en) 2013-05-09

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